温针灸治疗肩关节周围炎的临床研究进展

A clinical review on warm acupuncture and moxibustion in the treatment of shoulder periarthritis

肩关节周围炎(简称肩周炎)是临床常见病,其临床症状主要有肩周疼痛、活动障碍、肌肉萎缩等,其病程长,复发率高,不仅影响患者的日常生活,严重时还会影响患者的自理能力,降低患者的生活质量。本病又称“冻结肩”“五十肩”等。西医治疗以对症治疗为主,包括药物治疗、康复理疗及手术治疗等。药物治疗可以缓解疼痛,但无法改善患者肩部功能障碍,而且长期服用药物也会产生一定的不良反应。康复理疗为绿色疗法,对肩周炎治疗效果也显著,但治疗过程中要求患者行主动及被动运动,会使患者产生反抗和消极的心理,反而延误治疗。手术治疗也常常作为肩周炎患者的选择,但具有费用高、风险大、术后并发症多等缺点。临床经验发现温针灸疗法可以改善肩周炎的症状,且创性小、接受度高、绿色安全、治疗费用低。但同时发现单纯的温针灸疗法治疗肩周炎具有一定的局限性,对于一些病程较长或对单纯温针灸治疗效果不显著的患者,可根据个体化差异联合其他疗法治疗本病,如温针灸配合穴位贴敷、推拿、刺络放血拔罐、小针刀等。近年来,越来越多的临床医生采用温针灸及温针灸联合疗法治疗肩周炎,故文章对近年来用单纯温针灸和温针灸结合其他疗法治疗肩周炎进行综述。

Periarthritis of shoulder is a common clinical disease,and its clinical symptoms mainly include shoulder pain,movement disorders,muscle atrophy,etc.Because of the long course of the disease and the high recurrence rate,it can affect the daily life of patients.In severe cases,it will also affect the self-care ability of patients and reduce the quality of life of patients.This disease is also known as“frozen shoulder”,“fifty shoulder”and so on.Clinically,symptomatic treatment is the main treatment,including drug therapy,rehabilitation physiotherapy therapy and surgical treatment.Drug therapy can relieve pain,but it can not ameliorate the shoulder dysfunction of patients,and long-term use will also produce certain adverse reactions.Rehabilitation physiotherapy is a green therapy,which has a significant therapeutic effect on periarthritis of shoulder.However,during the treatment process,patients are asked to do some active and passive exercises,which causes patients to have resistance and negative psychology,and delays the treatment.Surgical treatment is often used as an option for patients with frozen shoulder,but it has the disadvantages of high cost,high risk,and more postoperative complications.Clinical studies have found that warm acupuncture and moxibustion can relieve the symptoms of scapulohumeral periarthritis.And warm acupuncture and moxibustion also has the advantages of less invasiveness,high acceptance,green safety and low treatment cost.But at the same time,it is found that the simple warm acupuncture and moxibustion therapy has certain limitations in the treatment of shoulder periarthritis.For some patients with a long course of disease or the effect of simple warm acupuncture and moxibustion therapy is not significant,we can treat this disease by warm acupuncture and moxibustion combined with other therapies according to individual differences,such as warm acupuncture and moxibustion combined with acupoint application,warm acupuncture and moxibustion combined with massage,warm acupuncture and moxibustion combined with blood letting and cupping,warm acupuncture and moxibustion combined with needle knife and so on.In recent years,more and more clinicians use warm acupuncture and moxibustion and its combination therapy to treat shoulder periarthritis.Therefore,the article reviews the treatment of shoulder periarthritis by simple warm acupuncture and moxibustion and warm acupuncture and moxibustion combined with other therapies in recent years.